? Dosing question....again!!!

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It depends on how closely you want to follow SLGS. It says to hold a dose for a week, then do a curve, and depending on the results, then increase by .25U. If you strictly follow SLGS, you'd hold the 3.25U dose for a week. Since you are using the AlphaTrak, the 3.5U dose got Frankie well below the equivalent of 90, even quite close to the TR reduction point.
 
You test more than enough to go to Tight Regulation if you're interested Sue

With TR we change dose more frequently in response to the numbers we see in the attempt to get them into pancreas healing numbers as much time as possible, but which one you want to use, SLGS or TR is totally your decision. With SGLS, (especially with numbers that high) my main worry would be letting glucose toxicity get a good stronghold due to leaving the dose too low, too long

Have you read the stickies that describe the 2 protocols?
 
Yes I have and I don't want to let Frankie go that low that the TR protocol shows. I had advice yesterday to increase and I attached the link. Is that wrong? Glucose toxicity has probably got a good hold already as these are low numbers for Frankie compared to a year ago when he was on Caninsulin!! Can I do a mixture of the protocols? Adjust dose according to figures, just not letting him go below 90?
 
Another consideration is how often you want to/can do increases. Some people can't monitor as much except weekends, and SLGS works for them because of that. Some members have their own change to the dosing guidelines. We do have a couple of members who do SLGS, but with lower reduction points than 90. For a time after Neko had her radiation therapy, she was racing down the dosing scale so I did TR with a reduction point of 70. Now I've reverted back to 50. You probably could chose to do TR, but with a reduction point of 90.
 
There are a few people that are using a number higher than 50 as a number for decreasing the dose. I forget who now. In my opinion you have to do what you feel comfortable doing. Most cats don't bounce as high as they get used to being in normal numbers.
 
Doing TR with a reduction point of 90 is a good idea, but on the other hand I cannot monitor much except weekends and evenimgs, and I do need sleep sometimes!!! So it looks like I will stick to SLGS and 3.25 units until the weekend and do a curve, unless it is blindingly obvious his nadirs are higher than 90, when I will just increase and give his poor ears a break.
 
It certainly is. And just caught a green 2.7 (49) which no doubt he will bounce high from. I can't understand how 3 units is not enough and 3.25 seems to be too much.
 
Congrats on the reduction - again. :D A dose that doesn't work one time, may work a second time. Often you have to dance up and down around a dose before they see enough green to hold the reduction. Good thing you didn't increase to 3.5!
 
Wasn't it just? Right, I'll try 3 units again in the morning and see where that takes me.
 
Sue484 said:
I can't understand how 3 units is not enough and 3.25 seems to be too much.
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I don't think it's certain the 3 units wasn't enough.
A day or so of higher than expected numbers doesn't necessarily mean that the insulin dose is insufficient per se. There are a lot of reasons why cat's blood glucose levels might spike or stay higher than normal. Sometimes there's a clear reason for it, sometimes we never know the reason.

I saw last night that you'd shot 3.25 on a preshot of 7.4 and the pattern looked awfully similar to the morning of 29/5 when he dropped low. At that point it looked like the dose was too high. It still seems to be the case.....

Well done on catching and handling that low number.
I do hope you managed to get some sleep, Sue. But I'm guessing you must be really tired this morning.....

Hugs,

Eliz
 
I am absolutely shattered. I even slept through a couple of alarms to check on Frankie, but luckily he is fine. He was just starting to bounce when I left for work (very late!!) this morning.
 
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